Nebraska Ignition Interlock | Schedule an Installation

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Please fill out the following form to get more information, or to schedule and installation.
Please fill in all required fields.

Name First and Last

Email Address

License Number

Date of Birth

Address 1 (Street Address)

Address 2 (City, State & Zip)

Emergency Contact (Next of Kin, Name and Phone))

Employer (Name and Phone)

County of DUI or Arrest

Required Interlock Term

On Probation? List Name and Phone

Phone (Where we can reach you)

How did you hear about us?

Additional Information or Questions?

Vehicle Year, Make, Model, Color, VIN and Plate #

Preferred Time and Date for Installation

You should receive a confirmation email after submission. Thank you for your interest in Smart Start. We appreciate the opportunity to earn your business!

Questions? Call 1-866-747-8278!

Smart Start of Kansas
Smart Start of Iowa
Smart Start of Nebraska
105 E Second Street
P.O. Box 697
Moundridge, Ks 67107